Dixit Avika, Kumar Neeta, Kumar Sanjiv, Trigun Vidyasagar
Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA.
Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
Indian J Community Med. 2019 Jan-Mar;44(1):4-8. doi: 10.4103/ijcm.IJCM_217_18.
Antimicrobial resistance (AMR) has emerged as a major threat to public health estimated to cause 10 million deaths annually by 2050. India carries one of the largest burdens of drug-resistant pathogens worldwide. NDM-1 reported in 2008, rapidly spread to other countries was named after India's capital. India is one of the largest consumers of antibiotics worldwide, and antibiotic sale is increasing rapidly. AMR develops when microbes develop mechanisms to evade the action of antimicrobials. The factors that contribute to AMR include irrational and overuse of antibiotics. In India, various actions have been taken including setting up of a National Task Force on AMR Containment (2010), "Chennai Declaration" by a consortium of the Indian Medical Societies (2012), Setting of Indian Council of Medical Research national surveillance network of laboratories, "Redline" campaign for educating public and National Action Plan on AMR 2017. There is a need integrating AMR education in medical education. India needs to start the subspecialty of infectious diseases and strengthen laboratory services. Every hospital needs to have an AMR policy including infection control, improvement in hygiene, and sanitation and antibiotic use. An element of research needs to be integrated into the AMR policy and encouragement of the pharmaceutical industry to develop "superbug antibiotics." Unless AMR is addressed effectively the gains made in health are likely to be lost.
抗菌药物耐药性(AMR)已成为对公共卫生的重大威胁,据估计到2050年每年将导致1000万人死亡。印度是全球耐药病原体负担最重的国家之一。2008年报告的NDM-1迅速传播到其他国家,并以印度首都命名。印度是全球最大的抗生素消费国之一,抗生素销售额正在迅速增长。当微生物产生逃避抗菌药物作用的机制时,就会出现AMR。导致AMR的因素包括抗生素的不合理使用和过度使用。在印度,已经采取了各种行动,包括成立抗菌药物耐药性控制国家特别工作组(2010年)、印度医学协会联盟发表的《钦奈宣言》(2012年)、建立印度医学研究理事会国家实验室监测网络、开展面向公众的“红线”运动以及《2017年抗菌药物耐药性国家行动计划》。有必要将AMR教育纳入医学教育。印度需要开设传染病亚专业并加强实验室服务。每家医院都需要制定AMR政策,包括感染控制、改善卫生和环境卫生以及抗生素使用。AMR政策需要融入研究要素,并鼓励制药行业开发“超级细菌抗生素”。除非有效应对AMR,否则在健康方面取得的成果可能会付诸东流。